Vasuyattakul S, Lertpattanasuwan N, Vareesangthip K, Nimmannit S, Nilwarangkur S
Renal Unit, Siriaj Hospital, Mahidol University, Bangkok, Thailand.
Nephron. 1995;69(3):311-3. doi: 10.1159/000188476.
We report on a patient with bromide intoxication, presenting with confusion, disorientation, and auditory and visual hallucinations after taking a sedative medication containing bromide (mixture menopause; 15 ml containing 1 g potassium bromide) for 1 month. Blood chemistry showed a high chloride level (176 mEq/l) and a negative anion gap (-60 mEq/l). The spurious hyperchloremia was due to interference of chloride ion determination by the ion-selective electrode method with a high level of bromide in serum: 352 mg/dl (44 mEq/l). In this case the only striking abnormality which alerted the physician to the possibility of halide intoxication was the negative anion gap. Hence, a negative anion gap is an important clue which leads to the diagnosis of halide intoxication.
我们报告了一例溴化物中毒患者，该患者在服用含溴化物的镇静药物（更年期合剂；15毫升含1克溴化钾）1个月后，出现意识模糊、定向障碍以及听觉和视觉幻觉。血液化学检查显示氯化物水平升高（176 mEq/L）且阴离子间隙为负值（-60 mEq/L）。假性高氯血症是由于离子选择性电极法测定氯离子时受到血清中高浓度溴化物的干扰：352 mg/dl（44 mEq/L）。在该病例中，唯一提醒医生注意卤化物中毒可能性的显著异常是阴离子间隙为负值。因此，阴离子间隙为负值是诊断卤化物中毒的重要线索。
